The University of Missouri has been an active participant in the activities of Cancer and Leukemia Group B since 1969. During this period, hundreds of patients have been entered on cooperative clinical trials. Our goals during the next funding year will be to continue our participation by enrollment of patients on the protocols of Cancer and Leukemia Group B and to participate in the development of new protocols and the analysis of those completed. The institutions involved include the University of Missouri-Columbia and the adjacent Harry S. Truman Veteran's Memorial Hospital, which share a common faculty. We will also use patients entered form the private practice of Dr. Joseph Muscato and associates at Boone Hospital Center and Columbia Regional Hospital, both in Columbia, Missouri. The University of Missouri-Kansas City and the Kirksville School of Osteopathic Medicine are also affiliates. As an institution, we are one of the largest contributions to CALGB respiratory cancers and significant contributors to breast cancer studies. We see relatively few acute leukemias (approximately one/month) but virtually all are entered onto protocols. We see a small number of untreated lymphoma patients and have added two new affiliates to increase accrual in these areas. The methodology involves the production of a protocol or treatment plan. The initial idea may come from an individual or derive from a meeting of one of the four disease committees (breast, lung, leukemia, and lymphoma) or a modality committee (chemotherapy, radiotherapy, immunotherapy, etc.). The protocol is modified, if necessary, and approved by the participating Modality Committees and then by the Executive Committee of CALGB. The final protocol is then submitted to the National Cancer Institute for approval. Once approved by the NCI, the protocol is activated at each of the participating institutions (following approval by their respective Institutional Review Boards). Patients are then enrolled until accrual goals are met, at which time the protocol is closed. The results are then tabulated, analyzed, and subsequently published. Sequential studies build upon the results of complied clinical trials.